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[成人Chiari畸形——5例手术病例]

[Adult Chiari malformation--five operative cases].

作者信息

Shimosegawa Y, Niizuma H, Shingai J, Suzuki J, Mochizuki H

出版信息

No Shinkei Geka. 1985 Mar;13(3):321-5.

PMID:4010882
Abstract

Recently, the diagnosis of adult Chiari malformation seems to have easy, because of the development of high resolution CT. During the last two years, we experienced with five cases of adult Chiari malformation diagnosed by CT metrizamide myelography. There were two males and three females aged from 15 to 55 years. Three cases had both foramen magnum compression and cerebellar symptoms. One of them had lower cranial nerve symptoms too. Another case had central cord symptoms, and the rest of them complained only of headache and vertigo. All cases underwent suboccipital craniectomy and upper cervical laminectomy. After operation, the cerebellar symptoms improved remarkably. Some of the central cord symptoms improved too. In one case with headache and vertigo, the result was unsuccessful. All cases were followed up in the outpatient clinic more than one year after operation. One case unchanged. Another case deteriorated seven months after surgery. The other three cases were in good condition. Operated cases of adult Chiari malformation are relatively rare in Japan. However, this type of malformation can be found easily by CT metrizamide myelography. A good many patients should be operated on carefully in consideration of their symptoms and severities.

摘要

近年来,由于高分辨率CT的发展,成人Chiari畸形的诊断似乎变得容易了。在过去两年中,我们遇到了5例经CT脊髓造影确诊的成人Chiari畸形病例。其中男性2例,女性3例,年龄在15至55岁之间。3例既有枕骨大孔受压又有小脑症状。其中1例还伴有低位颅神经症状。另一例有脊髓中央管症状,其余仅主诉头痛和眩晕。所有病例均接受了枕下颅骨切除术和上颈椎椎板切除术。术后,小脑症状明显改善。部分脊髓中央管症状也有所改善。1例头痛和眩晕患者手术效果不佳。所有病例术后均在门诊随访1年以上。1例无变化。另1例术后7个月病情恶化。其他3例情况良好。在日本,成人Chiari畸形的手术病例相对较少。然而,通过CT脊髓造影很容易发现这种畸形。许多患者应根据其症状和严重程度进行仔细的手术治疗。

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